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Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?

BACKGROUND: The most effective and radical treatment for pancreatic neuroendocrine tumors (PNETs) is surgical resection. Minimally invasive surgery has been increasingly used in pancreatectomy. Initial results in robotic distal pancreatectomy (RDP) have been encouraging. Nonetheless, data comparing...

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Autores principales: Zhang, Jiaqiang, Jin, Jiabin, Chen, Shi, Gu, Jiangning, Zhu, Yi, Qin, Kai, Zhan, Qian, Cheng, Dongfeng, Chen, Hao, Deng, Xiaxing, Shen, Baiyong, Peng, Chenghong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464919/
https://www.ncbi.nlm.nih.gov/pubmed/28477012
http://dx.doi.org/10.18632/oncotarget.17513
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author Zhang, Jiaqiang
Jin, Jiabin
Chen, Shi
Gu, Jiangning
Zhu, Yi
Qin, Kai
Zhan, Qian
Cheng, Dongfeng
Chen, Hao
Deng, Xiaxing
Shen, Baiyong
Peng, Chenghong
author_facet Zhang, Jiaqiang
Jin, Jiabin
Chen, Shi
Gu, Jiangning
Zhu, Yi
Qin, Kai
Zhan, Qian
Cheng, Dongfeng
Chen, Hao
Deng, Xiaxing
Shen, Baiyong
Peng, Chenghong
author_sort Zhang, Jiaqiang
collection PubMed
description BACKGROUND: The most effective and radical treatment for pancreatic neuroendocrine tumors (PNETs) is surgical resection. Minimally invasive surgery has been increasingly used in pancreatectomy. Initial results in robotic distal pancreatectomy (RDP) have been encouraging. Nonetheless, data comparing outcomes of RDP with those of laparoscopic distal pancreatectomy (LDP) in treating PNETs are rare. The aim of this study was to compare the safety and efficacy of RDP and LDP for PNETs. METHODS: From September 2010 to January 2017, operative parameters and perioperative outcomes in an initial experience with 43 consecutive patients undergoing RDP were collected and compared with those in 31 patients undergoing LDP. RESULTS: Patients undergoing RDP and LDP demonstrated equivalent age, sex, ASA score, tumor location and tumor size. Operating time, length of resected pancreas, postoperative length of hospital stay and rates of conversion to open, pancreatic fistula, transfusion and reoperation were not statistically different. Patients in the RDP group were associated with significantly higher overall (79.1 vs. 48.4 %, P = 0.006) and Kimura spleen preservation rates (72.1 vs. 16.1%, P < 0.001) and had reduced risk of excessive blood loss (50 vs. 200mL, P < 0.001). Oncological outcomes in this series were superior for the RDP group with more lymph node harvest for G2 and G3 PNETs (3.5 vs. 2, P = 0.034). CONCLUSIONS: Both RDP and LDP are efficacious and safe methods in treating PNETs located in the body or tail of pancreas. Robotic approach offers advantages with less intraoperative blood loss, higher spleen preservation rate and more lymph node harvest. It may be sensible to choose RDP for patients who fit indications for scheduled spleen preservation.
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spelling pubmed-54649192017-06-21 Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach? Zhang, Jiaqiang Jin, Jiabin Chen, Shi Gu, Jiangning Zhu, Yi Qin, Kai Zhan, Qian Cheng, Dongfeng Chen, Hao Deng, Xiaxing Shen, Baiyong Peng, Chenghong Oncotarget Clinical Research Paper BACKGROUND: The most effective and radical treatment for pancreatic neuroendocrine tumors (PNETs) is surgical resection. Minimally invasive surgery has been increasingly used in pancreatectomy. Initial results in robotic distal pancreatectomy (RDP) have been encouraging. Nonetheless, data comparing outcomes of RDP with those of laparoscopic distal pancreatectomy (LDP) in treating PNETs are rare. The aim of this study was to compare the safety and efficacy of RDP and LDP for PNETs. METHODS: From September 2010 to January 2017, operative parameters and perioperative outcomes in an initial experience with 43 consecutive patients undergoing RDP were collected and compared with those in 31 patients undergoing LDP. RESULTS: Patients undergoing RDP and LDP demonstrated equivalent age, sex, ASA score, tumor location and tumor size. Operating time, length of resected pancreas, postoperative length of hospital stay and rates of conversion to open, pancreatic fistula, transfusion and reoperation were not statistically different. Patients in the RDP group were associated with significantly higher overall (79.1 vs. 48.4 %, P = 0.006) and Kimura spleen preservation rates (72.1 vs. 16.1%, P < 0.001) and had reduced risk of excessive blood loss (50 vs. 200mL, P < 0.001). Oncological outcomes in this series were superior for the RDP group with more lymph node harvest for G2 and G3 PNETs (3.5 vs. 2, P = 0.034). CONCLUSIONS: Both RDP and LDP are efficacious and safe methods in treating PNETs located in the body or tail of pancreas. Robotic approach offers advantages with less intraoperative blood loss, higher spleen preservation rate and more lymph node harvest. It may be sensible to choose RDP for patients who fit indications for scheduled spleen preservation. Impact Journals LLC 2017-04-28 /pmc/articles/PMC5464919/ /pubmed/28477012 http://dx.doi.org/10.18632/oncotarget.17513 Text en Copyright: © 2017 Zhang et al. http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) (CC-BY), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Clinical Research Paper
Zhang, Jiaqiang
Jin, Jiabin
Chen, Shi
Gu, Jiangning
Zhu, Yi
Qin, Kai
Zhan, Qian
Cheng, Dongfeng
Chen, Hao
Deng, Xiaxing
Shen, Baiyong
Peng, Chenghong
Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title_full Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title_fullStr Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title_full_unstemmed Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title_short Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?
title_sort minimally invasive distal pancreatectomy for pnets: laparoscopic or robotic approach?
topic Clinical Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464919/
https://www.ncbi.nlm.nih.gov/pubmed/28477012
http://dx.doi.org/10.18632/oncotarget.17513
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